REGISTRATION FORM 2007

 

o I have not registered before o I have been a Medau member before  please tick one box

Name: (Mr / Mrs / Ms / Miss) ______________________________ Class Teacher: ________________
Address: ______________________________________________
______________________________________________ 
Postcode: __________
Tel. No.: Day __________________  Eve: ___________________ email: ___________
I enclose subscription £_________
donation £_________
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TOTAL £_________

Registration Fees for 2007
Standard £13.50
Overseas (outside UK) £15.00
Friend of Society £28.00

Please make your cheque payable to EMDP

Please send this form to:

Medau Movement 
1 Grove House
Foundry Lane
Horsham
West Sussex
RH13 5PL